Mauriello J A
Department of Ophthalmology, University of Medicine and Dentistry-New Jersey Medical School, Eye Institute of New Jersey, Newark 07107.
Ophthalmic Plast Reconstr Surg. 1990;6(3):218-20. doi: 10.1097/00002341-199009000-00013.
A patient with a tripod fracture had entrapment of the inferior rectus muscle after reconstruction of an orbital floor defect with an alloplastic implant. Prior to insertion of the implant, the operating surgeon reported no motility disturbance. An orbital computed tomography scan suggested that the implant impinged on the inferior rectus muscle. Because of persistent diplopia, the orbit was reexplored. An intraoperative forced duction test prior to removal of the implant was positive in the field of action of the inferior rectus muscle. An intraoperative forced duction test after removal of the implant was negative in the field of action of the inferior rectus muscle. Motility was markedly improved after removal of the implant. These findings confirm that the implant was the cause of the entrapment. The surgical technique utilized to minimize complications after orbital floor reconstruction with the implant is outlined in this article.
一名患有三脚架骨折的患者在使用异体植入物重建眶底缺损后出现下直肌嵌顿。在植入物插入之前，主刀医生报告没有眼球运动障碍。眼眶计算机断层扫描显示植入物压迫下直肌。由于持续复视，对眼眶进行了再次探查。在移除植入物之前进行的术中被动牵拉试验在下直肌作用区域为阳性。移除植入物后进行的术中被动牵拉试验在下直肌作用区域为阴性。移除植入物后眼球运动明显改善。这些发现证实植入物是嵌顿的原因。本文概述了使用该植入物进行眶底重建后将并发症降至最低的手术技术。
